title: Ready for policy? Stakeholder attitudes toward menu labelling in Toronto, Canada.
abstract: OBJECTIVE
  The purpose of this research was to assess key stakeholder attitudes regarding menu labelling in Toronto, the largest municipality in Canada. Menu labelling is a population health intervention where food-labelling principles are applied to the eating-out environment through disclosure of nutrient content of food items on restaurant menus at the point of sale. Menu-labelling legislation has been implemented in the United States, but has yet to be adopted in Canada. As provincial voluntary programs and federal analyses progress, municipal jurisdictions will need to assess the feasibility of moving forward with parallel interventions.
  
  
  METHODS
  Data were collected and analyzed in late 2011 to early 2012, including: a consumer eating-out module incorporated into a public health surveillance telephone survey (n=1,699); an online survey of independent restaurant operators (n=256); in-depth key informant interviews with executives and decision makers at chain restaurants (n=9); and a policy consultation with local restaurant associations.
  
  
  RESULTS
  Toronto residents, particularly men, younger adults, and those with higher income or education, frequently eat out. A majority indicated that nutrition information is important to them; 69% note that they currently use it and 78% reported they would use it if it were readily available. Resistance to menu-labelling requirements at the municipal level was articulated by franchise/chain restaurant executives and industry associations. Despite overall low interest among independent restaurant operators, 57% reported feeling some responsibility to provide nutrition information and 50% believed it could be good for business.
  
  
  CONCLUSIONS
  This research supports earlier literature that indicates strong public support for menu labelling alongside perceived barriers among the restaurant and foodservices sector. Leverage points for effective operator engagement for menu-labelling adoption were identified, nonetheless, highlighting the need for public health support.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. catherine.mah@utoronto.ca
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Mah
authors.forename: Loren
authors.initials: L
authors.lastname: Vanderlinden
authors.forename: Dia
authors.initials: D
authors.lastname: Mamatis
authors.forename: Donna L
authors.initials: DL
authors.lastname: Ansara
authors.forename: Jennifer
authors.initials: J
authors.lastname: Levy
authors.forename: Lisa
authors.initials: L
authors.lastname: Swimmer
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002170:Canada; D005260:Female; D005515:Food Labeling / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D036301:Qualitative Research; D012147:Restaurants / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Nutrition; local government; public policy